Honestly, I think this is a question that is not asked enough by patients. Why do I need an Rx orthotic doc? Couldn’t I do just as well with a less expensive stock insert? And the answer is that in many cases, yes, you can do just as well with a prefabricated insert. The prefab insert may perform just as well as the more expensive Rx orthotic.
Rx orthotics, or what many doctors call orthoses, are foot supports made from a mold or impression of the patient’s foot. Impressions can be made in a number of ways, most common of which is plaster or foam. New methods include computer scanning with direct transfer of the digital image to the orthotics lab.
But what can an Rx orthotic do for the patient? That really depends upon the condition that is being treated. An orthotic is really a combination of many different sciences. First is the science of biomechanics. Biomechanics is how the foot functions. If the biomechanics are not optimal (called pathomechanics) then an orthotic may help to restore normal foot and ankle biomechanics.
Second is materials science. Do you need a rigid (functional) orthotic. What about semi-rigid? Or softer, often called an accommodative orthotic? The material and construct of the orthotic really does matter in the success of the orthotic.
I learned a big lesson when I owned a shoe store. I would go in on Saturday morning to act as the doctor and helped to solve fitting issues for the shoe store staff. Once or twice a month I would speak with a customer who had the greatest pair of orthotics, but couldn’t fit them into their shoes. Their question was; “Do you have any shoe that I can use with my orthotics?” So remember, from an academic standpoint, orthotics may seem like a great solution for a problem. But from a practical standpoint, sometimes they just aren’t used. And that can be true for a number of reasons. They may be too bulky, they may be uncomfortable or they may just not be compatible with the shoes the patient prefers to wear. There’s many a pair of Rx orthotics that are sitting on the bottom of the closet collecting dust.
So where to start when considering a pair of orthotics? Just like everything else in life, sometimes it’s best to start out as simply as possible. And that starting point might be with a non-Rx insert. There’s a number of new suppliers of prefab supports that offer a great product. And often, the insert can act as a base for modification. That means that your doc can get you into an inexpensive insert and use it as the platform on which modifications can be made. And if you like the way the prefab insert works and you want to take a step further into a more corrective device, then perhaps the Rx orthotic is indicated.
Written by Jeffrey A. Oster, DPM
Medical Director
Myfootshop.com
